Treating unexplained infertility: Answers still needed
In this study, a national network of investigators looked at how the drug letrozole compared with two standard drugs to stimulate ovulation. Letrozole works to stimulate ovulation through a different path than traditional fertility medications. Investigators assigned cver a thousand couples with unexplained infertility to as many as four rounds of treatment with either letrozole or one of two “standard treatments”: gonadotropin (Menopur is one brand name) or clomiphene (Clomid is a common brand name). The results: live birth rates were lower in the women who took letrozole (19%) as compared with gonadotropin (32%), but were statistically similar to clomiphene (23%). On the other hand, rates of multiple pregnancies (all twins and triplets in this study) were higher in the gonadotropin group (all the triplets in were in this treatment group) than in the letrozole and clomiphene groups (which had about the same rate). Hardly a home run for those who were hoping letrozole would be the answer. Over all, the numbers indicate that for couples with unexplained infertility, these alternatives to IVF may help them achieve a pregnancy — but success is hardly a sure thing. The drugs that bring a higher chance of pregnancy, also bring a greater chance that pregnancy will be a high-risk one. While disappointing, the results argue for more work to optimize fertility therapies. A very important part of this work — whether we’re talking about ovulation induction ...
Individuals with a 47,XXY karyotype usually present with a male phenotype due to the additional Y chromosome. In this paper, we describe a 47,XXY female who was pregnant with a fetus of the same karyotype based on chromosome analysis of amniotic fluid cells. Further analysis of her Y chromosome indicated that the additional Y chromosome contains noSRYgene on the short arm but carries the azoospermia factor region on the long arm, including azoospermia factor a, b and c (AZFa, AZFb, AZFc). This region may influence her female phenotype. Fertile females with a 47,XXY karyotype and loss ofSRY are extremely rare. This paper is...
1) To determine the effects of aging on the pelvic floor in the absence of pregnancy and childbirth-related changes. 2) Test the hypothesis that aging leads to descent of the pelvic floor structures.
To illustrate technique for the planned total laparoscopic hysterectomy of a morbidly obese patient with a cesarean scar ectopic pregnancy.
To demonstrate a minimally invasive robot-assisted technique to resect a cesarean scar ectopic pregnancy also involving the cervix and subsequent metroplasty.
Cornual ectopic pregnancy (CEP) is a rare and makes up only 2-4% of ectopic pregnancies. This video describes a case of CEP that was successfully treated with a laparo-endoscopic single-site (LESS) wedge resection of the uterus.
To evaluate peri-operative clinical results as well as fertility and perinatal outcomes of women after laparoscopic cornual resection for interstitial pregnancy.
CONCLUSIONS: Most participants reported having healthy life habits, which they believe influence on disease control. Among the investigated parameters, only the habit of not smoking was associated with the absence of hypertensive peaks; the other habits did not present statistical association with the comorbidities. PMID: 30785546 [PubMed - in process]
CONCLUSION: The considerations and suggestions of the pregnant women guided the nurses in the development of the groups, which became strategic spaces of care, acquisition of knowledge and establishment of trust relationships with the nurses, with a consequent impact on the quality of care. PMID: 30785543 [PubMed - in process]
Authors: Vitrone M, Parrella A, Albisinni R, Durante-Mangoni E, Zampino R Abstract Current regimens of direct-acting antiviral agents (DAA) are effective and safe for chronic hepatitis C (CHC). However, DAA often interfere with concomitant medications. We treated seven CHC patients with DAA who were on chronic anticoagulant treatment with warfarin, and describe the dynamics of prothrombin time, providing novel data, useful for the clinician. PMID: 30784359 [PubMed - as supplied by publisher]
This report presents baseline estimates of the use of these preventive services before the publication of QFP that can be used to monitor progress toward improving the quality of preventive care received by women and men of reproductive age. PERIOD COVERED: 2011-2013. DESCRIPTION OF THE SYSTEM: Three surveillance systems were used to document receipt of preventive health services among women and men of reproductive age as recommended in QFP. The National Survey of Family Growth (NSFG) collects data on factors that influence reproductive health in the United States since 1973, with a focus on fertility, sexual act...